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Systematic review of pre-clinical therapies for post-operative atrial fibrillation

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  • Chanhee Seo
  • Connor Michie
  • Benjamin Hibbert
  • Darryl R Davis

Abstract

Background: Post-operative atrial fibrillation (POAF) is a frequent cardiothoracic surgery complication that increases hospital stay, mortality and costs. Despite decades of research, there has been no systematic overview and meta-analysis of preclinical therapies for POAF in animal models. Methods: We performed a systematic search of MEDLINE and EMBASE from their inception through September 2020 to determine the effect of preclinical POAF therapies on primary efficacy outcomes using a prospectively registered protocol (CRD42019155649). Bias was assessed using the SYRCLE tool and CAMARADES checklist. Results: Within the 26 studies that fulfilled our inclusion criteria, we identified 4 prevention strategies including biological (n = 5), dietary (n = 2), substrate modification (n = 2), and pharmacological (n = 17) interventions targeting atrial substrate, cellular electrophysiology or inflammation. Only one study altered more than 1 pathophysiological mechanism. 73% comprised multiple doses of systemic therapies. Large animal models were used in 81% of the studies. Preclinical therapies altogether attenuated atrial fibrosis (SMD -2.09; 95% confidence interval [CI] -2.95 to -1.22; p

Suggested Citation

  • Chanhee Seo & Connor Michie & Benjamin Hibbert & Darryl R Davis, 2020. "Systematic review of pre-clinical therapies for post-operative atrial fibrillation," PLOS ONE, Public Library of Science, vol. 15(11), pages 1-17, November.
    • Handle: RePEc:plo:pone00:0241643
    DOI: 10.1371/journal.pone.0241643
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